Dr. Daniel Tsoi, Auburn Cardiologist, puts Medically Speaking Radio to the test by having Dr. Vaughan perform an exercise treadmill test. In addition to the exercise treadmill test, we also discuss other ways that a Cardiologist evaluates a patient for heart disease and the resulting treatments.. ...
To determine the prognostic value of the treadmill exercise test, we evaluated 2842 consecutive patients with chest pain who had both treadmill testing cardiac catheterization. The population was randomly divided into two equal-sized groups and the Cox regression model was used in one to form a treadmill score that was then validated in the other group. The final treadmill score was calculated as follows: exercise time - (5 X ST deviation) - (4 X treadmill angina index). Using this treadmill score, 13% of the patients were found to be at high risk; 53%, at moderate risk; and 34%, at low risk. The treadmill score added independent prognostic information to that provided by clinical data, coronary anatomy, and left ventricular ejection fraction: patients with three-vessel disease with a score of -11 or less had a 5-year survival rate of 67%, and those with a score of +7 or more had a 5-year survival rate of 93%. The treadmill score was useful for stratifying prognosis in patients with suspected ...
This Duke Treadmill Score calculator diagnoses and prognoses coronary artery disease based on ECG testing, presence and severity of angina during exercise.
TY - JOUR. T1 - Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise treadmill test. AU - Laurinavicius, A. G.. AU - Bittencourt, M. S.. AU - Blaha, M. J.. AU - Nary, F. C.. AU - Kashiwagi, N. M.. AU - Conceiçao, R. D.. AU - Meneghelo, R. S.. AU - Prado, R. R.. AU - Carvalho, J. A.M.. AU - Nasir, K.. AU - Blumenthal, R. S.. AU - Santos, R. D.. PY - 2016/8/1. Y1 - 2016/8/1. N2 - Aims: Non-alcoholic hepatic steatosis (HS) is associated with hypertension and increased cardiovascular risk. While Blood pressure hyper-reactive response (HRR) during peak exercise indicates an increased risk of incident hypertension and increased cardiovascular risk, no data on the association of non-alcoholic HS and HRR exists. In this study, we have evaluated the association of HS with HRR. Methods: We included 13 410 consecutive individuals with a mean age: 42.4 6 8.9 years, 3561 (26.6%) female with normal resting blood pressure and without a previous ...
I have suffered from panic attacks for over 20 years. I am 55 years old. I recently went in for my routine physical and had a panic attack during the treadmill stress test. The Cardiologist said I h...
TY - JOUR. T1 - Long-term outcome of patients with intermediate-risk exercise electrocardiograms who do not have myocardial perfusion defects on radionuclide imaging. AU - Gibbons, Raymond J. AU - Hodge, David O.. AU - Berman, Daniel S.. AU - Akinboboye, Olakunle O.. AU - Heo, Jaekyeong. AU - Hachamovitch, Rory. AU - Bailey, Kent R. AU - Iskandrian, Ami E.. PY - 1999/11/23. Y1 - 1999/11/23. N2 - Background - The appropriate management of patients with intermediate- risk Duke treadmill scores is not established. The purpose of this study was to determine the long-term risk of subsequent cardiovascular events in patients with an intermediate-risk treadmill score who do not have myocardial perfusion defects on radionuclide imaging. Methods and Results - The existing databases of the nuclear cardiology laboratories of 4 academic institutions were searched retrospectively. A total of 4649 patients were identified who had intermediate-risk Duke treadmill scores (- 10 to 4), normal or near- normal ...
Introduction: Cardiovascular fitness is an important goal in cardiac rehabilitation (CR) programs and is predictive of outcomes. We sought to determine the utility of a novel clinical treadmill score in determining prognosis of coronary artery disease (CAD) patients after CR. Methods: Demographic, clinical and exercise data of 262 patients (mean age 55.8 ± 10.1 years) who completed an outpatient CR program were analyzed. The FIT treadmill score was determined prior to program initiation and after completion. Patients were classified according to risk category using the FIT scores after CR completion and were followed up for the occurrence of 10 year all cause mortality. Results: On median follow up of 10.3 years, 52 patients died. An improvement of the FIT treadmill score by 18.2 points was associated with a 21% reduction in mortality (multivariate-adjusted Hazard Ratio 0.79, 95% CI 0.56-1.08, P≤0.05). Kaplan-Meier survival curves showed increased occurrence of mortality in the high-risk group. After
This page includes the following topics and synonyms: Exercise Stress Test, Exercise Electrocardiography, Duke Treadmill Score, Exercise Treadmill Test.
TY - JOUR. T1 - Treadmill Exercise Test and Pharmacologic Stress Echocardiography for Womens Coronary Artery Disease. AU - Lee , Gawain Shih-I. AU - Huang , Lien-Chi. AU - Kuo, San-Dar. AU - Liu, Ju-Chi. AU - Chang, Nen-Chung. PY - 2008/9. Y1 - 2008/9. KW - Pharmacologic stress echocardiography. KW - Duke activity status index questionnaire. KW - Duke treadmill score. UR - http://readopac2.ncl.edu.tw/nclJournal/search/detail.jsp?sysId=0006563988&dtdId=000040&search_type=detail&la=ch. M3 - Article. VL - 2. SP - 133. EP - 137. JO - 臺灣心臟超音波學會雜誌. JF - 臺灣心臟超音波學會雜誌. IS - 3. ER - ...
Background: Submaximal exercise tests use heart rate responses to low-to-moderate intensity activity in order to predict cardiorespiratory fitness (VO2max). Currently used tests may be inappropriate for obese populations as obese women have altered heart rate responses to exercise. The purpose of this study is to test the validity of the Modified Bruce Protocol submaximal treadmill test in obese women. Methods: Normal-weight (NW) women and obese (OB) women completed the Modified Bruce submaximal treadmill test (to predict VO2max using previously validated equations) and a maximal graded exercise test on a treadmill using the Standard Bruce Protocol (to obtain an actual VO2max) on two separate occasions. The relationships between actual and predicted VO2max values were analyzed using correlation coefficients. Results: 9 NW (age: 23.1 ± 8.0 y, body fat: 23.5 ± 4.9%) and 9 OB (age: 22.0 ± 4.8 y, body fat: 36.9 ± 4.4%) women participated. Actual and predicted VO2max values were not correlated ...
In this study we assessed whether various responses to exercise testing could be quantified in order to derive the probabilities of presence of coronary disease, and if present, to assess its severity. A treadmill score based on the exercise response was determined in 405 patients who had both treadmill tests and coronary angiograms. The score was derived using discriminant function analysis, by weighting and combining depth and configuration of ST depression (downsloping, horizontal or slowly upsloping), timing onset and duration of ischemia, grading ventricular arrhythmias, heart rate and blood pressure change, coexistence of exercise-induced chest pain and sex. The treadmill score was effective in detecting coronary disease (lesions with an greater than or equal to 50% narrowing), with a predictive accuracy (PA) (probability that a subject manifesting a positive test has disease) of 87%, a true negative rate (TNR) (probability of a subject with a negative test having no disease) of 80%, and ...
As noted earlier, the EKG is constantly displayed on the monitor. It is also recorded on paper at one minute intervals. The physician pays particular attention to the heart rate, blood pressure, changes in the EKG pattern, irregular heart rhythm, and the patients appearance and symptoms. The treadmill is stopped when the patient achieves a target heart rate (this is 85% of the maximal heart rate predicted for the patients age). However, if the patient is doing extremely well at peak exercise, the treadmill test may be continued further. The test may be stopped prior to achievement of the target heart rate if the patient develops significant chest discomfort, shortness of breath, dizziness, unsteady gait, etc., or if the EKG shows alarming changes or serious irregular heartbeats. It may also be stopped if the blood pressure (BP) rises or falls beyond acceptable limits. Please note that the systolic BP (upper number) may normally rise to 200 at peak exercise. At the same time, the diastolic BP ...
A total of 9,569 consecutive patients were included, of which 46.8% were women. Overall, exercise capacity and heart rate recovery were significantly associated with all-cause death. Exercise capacity, chest pain, and ST-segment deviations were significantly associated with subsequent MI. In general, the relationship between ETT variables and outcomes was similar between men and women, except for abnormal exercise capacity, which had a significantly stronger association with death in men (hazard ratio [HR], 2.89; 95% confidence interval [CI], 1.89-4.44), but not for women (HR, 0.99; 95% CI, 0.52-1.93). In contrast, chronotropic incompetence had a significantly stronger relationship with MI for women (HR, 2.79; 95% CI, 0.94-8.27) than for men (HR, 1.29; 95% CI, 0.74-2.20).. ...
This randomised, controlled study showed that myocardial ischaemia in hypercholesterolaemic patients with normal coronary arteries, as indicated by ST segment depression during exercise stress tests, can be ameliorated by cholesterol lowering drug treatment. Statin treatment reduced the number of patients with positive exercise test results and improved exercise endurance (higher maximum heart rate and lower maximum diastolic blood pressure). In contrast, diet alone produced little change in cholesterol and did not improve myocardial ischaemia induced by exercise testing. The beneficial effect of lowering plasma cholesterol concentrations by statin treatment may be related to normalisation of coronary endothelial function.. Research has shown that coronary risk factors, such as increased plasma LDL cholesterol20 21 and oxidised LDL,22adversely affect endothelial vasomotor responses in humans. Intracoronary infusion of acetylcholine has been shown to dilate normal human coronary arteries by ...
Background Oxygen uptake efficiency (OUE), the relation between oxygen uptake (VO2) and minute ventilation (VE), differs between healthy children and children with heart disease. This study aimed to investigate the normal response profiles of OUE during a progressive cardiopulmonary exercise test. Design: Cross-sectional. Methods Healthy children between eight and 19 years of age (114 boys and 100 girls, mean ± SD age 12.7 ± 2.8 years) performed a maximal cardiopulmonary exercise test. Peak VO2 (VO2peak), ventilatory threshold and peak VE were determined. OUE was determined by the OUE plateau (OUEP), OUE at the ventilatory threshold (OUE@VT) and OUE slope (OUES). Results OUEP (42.4 ± 4.6) and OUE@VT (41.9 ± 4.7) were similar and less variable than OUES (2138 ± 703). OUEP correlated strongly with OUE@VT (r = 0.974); however, OUEP was weak-to-moderately correlated with VO2peak (r = 0.646), the ventilatory threshold (r = 0.548) and OUES (r = 0.589). OUES correlated strongly with VO2peak (r = ...
BACKGROUND:Exercise testing has limited efficacy for identifying coronary artery disease (CAD) in the absence of anginal symptoms. Exercise echocardiography is more accurate than standard exercise testing, but its efficacy in this situation has not been defined. We sought to identify whether the Duke treadmill score or exercise echocardiography (ExE) could be used to identify risk in patients without anginal symptoms. METHODS:We studied 1859 patients without typical or atypical angina, heart failure, or a history or ECG evidence of infarction or CAD, who were referred for ExE, of whom 1832 (age 51+/-15 years, 944 men) were followed for up to 10 years. The presence and extent of ischaemia and scar were interpreted by expert reviewers at the time of the original study. RESULTS:Exercise provoked significant (>0.1mV) ST segment depression in 215 patients (12%), and wall motion abnormalities in 137 (8%). Seventy-eight patients (4%) died before revascularization, only 17 from known cardiac causes. The ...
BACKGROUND: Important modern prognostic markers such as heart rate recovery (HRR), chronotropic index, delayed systolic blood pressure (SBP) response and Duke treadmill score (DTS) have been evaluated by treadmill exercise testing. Their value in bicycle exercise testing is unclear. METHODS: Patients (n=211, age 64+/-10; 75% male) with known or suspected coronary artery disease randomly underwent either bicycle (n=105) or treadmill (n=106) exercise electrocardiography. They were matched for age, gender, body mass index, hypertension, smoking, lipid status, prevalence of diabetes, medication, haemoglobin level, extent of coronary artery disease and left ventricular ejection fraction. RESULTS: Despite a higher peak heart rate (pHR) patients stressed by treadmill had a slower drop in HR during the early phase of recovery with a significantly higher rate of abnormal HRR (pHR; HR 1 min into recovery | or =12 bpm) with 37% in treadmill versus 19% in bicycle (P=0.004). Abnormally delayed SBP response [(SBP 1
To determine if patterns of ST depression or elevation during exercise testing provide reliable information about the location of an underlying coronary lesion, we studied 452 consecutive patients with one-vessel disease who underwent treadmill testing. Exercise ST changes were classified as elevation or depression and by lead groups involved. The ST depression occurred most commonly in leads V5 or V6 regardless of which coronary artery was involved. In contrast, anterior ST elevation indicated left anterior descending coronary disease in 93% of cases, and inferior ST elevation indicated a lesion in or proximal to the posterior descending artery in 86% of cases. Furthermore, anterior ST elevation in leads without diagnostic Q waves usually indicated a high-grade, often proximal, left anterior descending stenosis, whereas anterior ST elevation in leads with Q waves usually indicated a totally occluded left anterior descending coronary artery. Thus, ST elevation during exercise testing, although ...
TY - JOUR. T1 - Comparison of Echocardiography at Peak Exercise and After Bicycle Exercise in Evaluation of Patients with Known or Suspected Coronary Artery Disease. AU - Presti, Charles F.. AU - Armstrong, William F.. AU - Feigenbaum, Harvey. PY - 1988. Y1 - 1988. N2 - To determine if echocardiography done immediately after bicycle exercise provides the same information as imaging at peak exercise, we evaluated 104 consecutive patients being studied for coronary artery disease. Interpretable exercise echocardiograms were obtained in 96 patients (92%), 29 of whom had a new wall motion abnormality detected with exercise echocardiography. Of these 29 patients, 10 had a wall motion abnormality detected in apical views obtained during peak exercise that resolved by the time apical imaging was performed after exercise. Three of these 10 patients, however, had wall motion abnormalities in parasternal views taken after exercise in areas adjacent to the wall motion abnormality imaged at peak exercise. ...
Electrocardiograms were recorded during and at 2-min intervals following maximal treadmill exercise in 100 patients and were correlated with coronary arteriograms, left ventricular cineangiograms, and resting and exercise cardiac hemodynamics. The incidence and extent of exercise-induced ischemic S-T segment depression increased significantly (P , 0.01) with increasing extent of coronary artery disease (CAD). A criterion of abnormality of 1.0 mm or greater S-T depression most accurately predicted the presence of CAD with a specificity (true negative) of 89% and a sensitivity (true positive) of 62%. Criteria of ≧0.75 and ≧0.5 mm S-T depression offered improved sensitivities (68 and 84%, respectively) but markedly reduced specificities (78 and 57%, respectively).. A significant correlation (P , 0.005) was found between increasing extent of exercise-induced S-T segment depression and the pulmonary artery wedge pressure during exercise. There were no correlations between the presence or extent ...
TY - JOUR. T1 - Design and validation of an interpretative strategy for cardiopulmonary exercise tests. AU - Schmid, Andreas. AU - Schilter, Daniel. AU - Fengels, Ingo. AU - Chhajed, Prashant N.. AU - Strobel, Werner. AU - Tamm, Michael. AU - Brutsche, Martin H.. PY - 2007/11. Y1 - 2007/11. N2 - Background and objective: Cardiopulmonary exercise testing (CPET) is a common investigation for the evaluation of exertional dyspnoea. At present, there is no consensus on the best interpretative strategy and none of the available algorithms have been validated. The aim of this study was to develop and validate a standardized strategy for the interpretation of CPET. Methods: This study analysed 199 CPETs from patients with exertional dyspnoea. Using a set of 100 CPETs a standardized interpretation using a four-step approach was developed that scored: examination quality, performance, exercise limitation and cofactors. A second set of 99 CPETs was interpreted by two experts in the field, initially ...
symptoms and signs of heart disease may become unmasked by exposing the heart to the stress of exercise. Get an online appointment or call (713) 599-1144
BACKGROUND: The ventilatory cost of carbon dioxide (CO2) elimination on exercise (VE/VCO2) is increased in chronic heart failure (CHF). This reflects increased physiological dead space ventilation secondary to mismatching between perfusion and ventilation during exercise. The objectives of this study were to investigate the relation of this increased VE/VCO2 slope to the syndrome of CHF or to limitation of the exercise related increase of pulmonary blood flow, or both. PATIENTS AND METHODS: Maximal treadmill exercise tests with respiratory gas analysis were performed in 45 patients with CHF (defined as resting left ventricular ejection fraction | 40% on radionuclide scan); 15 normal controls; 23 patients with coronary artery disease and normal resting left ventricular function; and 13 pacemaker dependent patients (six with and seven without CHF) directly comparing exercise responses in rate responsive and fixed rate mode. RESULTS: Patients with CHF had a steeper VE/VCO2 slope than normal controls: this
INTRODUCTION: A treadmill exercise test requiring a low initial metabolic rate that then increments the work rate linearly to reach the subjects limit of tolerance in approximately 10 min would have significant advantages for exercise testing and rehabilitation of subjects with impaired exercise tolerance. METHODS: We developed such a treadmill protocol that uses a linear increase in walking speed coupled with a curvilinear increase in treadmill grade to yield a linear increase in work rate. RESULTS: Twenty-two healthy, sedentary subjects performed both this new treadmill protocol and a standard cycle ergometry ramp protocol eliciting similar work rate profiles. The low initial treadmill speed and grade resulted in a low initial metabolic rate, commensurate with unloaded pedaling on a cycle ergometer (average [OV0312]O2 = 0.54 +/- 0.16 vs 46 +/- 0.12 l x min(-1)). This combination of simultaneous increase in speed and grade yielded a linear work rate and its oxygen uptake response (R2 = 0.96 ...
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BACKGROUND: Heart rate recovery (HRR) has been identified as a reliable predictor of cardiac mortality, correlated with autonomic tone. In a model of sequential exercise testings, we investigated the reproducibility of HRR and the association between HRR modification and myocardial adaptation to ischemia. METHODS: We studied 128 patients (mean age 62 +/- 9 years, 83% males) with angiographically documented coronary artery disease (CAD) and a first positive exercise testing, who agreed to undergo a second exercise testing after 24 hours. RESULTS: HRR was increased from 25 +/- 10 beats/min at the first exercise testing to 30 +/- 13 beats/min at the second exercise testing (P | 0.001). Thereafter, participants were divided into two groups: Group I comprised 88 patients who presented augmentation of the HRR in the first compared to the second exercise testing, while group II comprised 40 patients who presented unchanged or reduced HRR. The rate-pressure product (RPP) at 1 mm ST-segment depression (ischemic
Left atrial volume (LAV) and exercise capacity are important prognostic determinants of cardiovascular risk. Exercise intolerance and increased LAV are expected in patients with diastolic dysfunction. While dyspnea is the symptom reported by the patient and considered subjective, exercise capacity obtained by exercise testing provides an objective measure of cardiovascular fitness. The objective of this study is to determine the relationship between LAV index and exercise capacity in patients with isolated diastolic dysfunction who presented with exertional dyspnea. We studied consecutive patients with dyspnea who underwent treadmill exercise testing and transthoracic echocardiography on the same day. LAV was assessed using the biplane area-length method. Symptom-limited exercise testing was performed immediately after echocardiography. Patients with coronary artery disease, valvular or congenital heart disease, left ventricular systolic dysfunction, pulmonary hypertension or positive exercise test were
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Maximal heart rate: less than 100 bpm; Maximal heart rate: 100 to 129 bpm; Maximal heart rate: 130 to 159 bpm; Maximal heart rate: 160 to 189 bpm; Maximal heart rate: 190 to 220 bpm; Exercise ST depression: 1-2 mm; Exercise ST depression: > 2 mm; Age >65 years; Age 50 to 65 years; Angina history: definite/typical; Angina history: probable/atypical; Angina history: non-cardiac pain; Smoking; Diabetes; Exercise test induced angina: occurred; Exercise test induced angina: reason for stopping; Estrogen status: positive; Estrogen status: ...
The exercise stress test is a useful screening tool for the detection of significant coronary artery disease. Documentation of the patients symptoms, medications, past and current significant illnesses, and usual level of physical activity helps the physician determine if an exercise stress test is appropriate. The physical examination must include consideration of the patients ability to walk and exercise, along with any signs of acute or serious disease that may affect the test results or the patients ability to perform the test. The test report contains comments about the maximal heart rate and level of exercise achieved, and symptoms, arrhythmias, electrocardiographic changes and vital signs during exercise. This report allows the clinician to determine if the test was
TY - JOUR. T1 - Manipulating graded exercise test variables affects the validity of the lactate threshold and VO2peak. AU - Jamnick, Nicholas A. AU - Botella, Javier. AU - Pyne, David B. AU - Bishop, David J. PY - 2018. Y1 - 2018. N2 - BACKGROUND: To determine the validity of the lactate threshold (LT) and maximal oxygen uptake ([Formula: see text]) determined during graded exercise test (GXT) of different durations and using different LT calculations. Trained male cyclists (n = 17) completed five GXTs of varying stage length (1, 3, 4, 7 and 10 min) to establish the LT, and a series of 30-min constant power bouts to establish the maximal lactate steady state (MLSS). [Formula: see text] was assessed during each GXT and a subsequent verification exhaustive bout (VEB), and 14 different LTs were calculated from four of the GXTs (3, 4, 7 and 10 min)-yielding a total 56 LTs. Agreement was assessed between the highest [Formula: see text] measured during each GXT ([Formula: see text]) as well as between ...
Saunas have been associated with increases in heart rate, changes in systolic blood pressure and ventricular ectopy. Electrocardiographic (ECG) changes have also been noted after patients have been exposed to the supraphysiologic temperatures in a sauna (usually greater than 80°C [176°F]). Giannetti and colleagues conducted a study to determine whether sauna use was well tolerated in patients with stable coronary artery disease (CAD).. Patients with known CAD, exercise-induced ST segment depression and reversible perfusion defects (on technetium-99m sestamibi scans) were included. Patients were excluded if they had a history of myocardial infarction, unstable angina or angioplasty within the previous three months.. Patients with heart failure, uncontrolled hypertension or ventricular arrhythmias were also excluded. The study consisted of three visits. At one visit patients underwent a symptom-limited exercise stress test and nuclear scintigraphy. In the exercise stress test, time to at least 1 ...
Background: Myocardial perfusion scintigraphy (MPS) is a well-established diagnostic tool. The sensitivity and specificity of single photon emission computed tomography (SPECT) MPS to detect significant coronary lesion were 86% and 74%, respectively. The aim of this study was to examine the role of serum copeptin in evaluation of MPS.. Methods: Sixty-two consecutive patients underwent both SPECT MPS using 99mTc-sestamibi and transthoracic echocardiography were enrolled prospectively. Age, gender, height, weight, presence of cardiovascular risk factors were recorded. Exercise treadmill test (ETT) with modified Bruce protocol was used to induce coronary ischemia during MPS. While performing MPS, blood samples for serum copeptin level were drawn three times at pre-exercise, at the peak of ETT, and 6 h after ETT, respectively. The patients were enrolled into three groups according to MPS results (normal, equivocal and ischemia).. Results: The study included 62 patients (23 with normal, 20 with ...
Preoperative anaemia and low exertional oxygen uptake are both associated with greater postoperative morbidity and mortality. This study reports the association among haemoglobin concentration ([Hb]), peak oxygen uptake ( peak) and anaerobic threshold (AT) in elective surgical patients. Between 1999 and 2011, preoperative [Hb] and cardiopulmonary exercise tests were recorded in 1,777 preoperative patients in four hospitals. The associations between [Hb], peak and AT were analysed by linear regression and covariance. In 436 (24.5%) patients, [Hb] was |12 g dl-1 and, in 83 of these, |10 g dl-1. Both AT and
The current outpatient evaluation for angina in low and intermediate risk patients typically starts with a functional assessment for coronary ischemia. Exercise treadmill testing is often selected as the initial diagnostic modality for coronary artery function. However, exercise treadmill testing is limited by its moderate sensitivity and specificity, often resulting in further cardiac resource utilization for patient risk stratification and reassurance. With the advent of coronary multislice computed tomography (MSCT) angiography, coronary artery anatomy can now be evaluated noninvasively. Despite its impressive performance characteristics, the role of coronary MSCT angiography in the outpatient evaluation of angina remains undefined.. CT-EXTRA compares the impact on patient safety and downstream resource utilization of a novel initial diagnostic strategy employing the addition of coronary MSCT angiography to exercise treadmill testing with a standard diagnostic strategy of exercise treadmill ...
http://www.translational-medicine.com/content/12/1/20/abstract Decreased oxygen extraction during cardiopulmonary exercise test in patients with...
OBJECTIVES: The purpose of this study was to determine the antihypertensive agent(s) more likely to mitigate an exaggerated rise in exercise blood pressure (BP) in hypertensive patients. BACKGROUND: An exaggerated rise in exercise BP is associated with increased cardiovascular risk. There are no recommendations for treating such response. METHODS: Participants were hypertensive men (n = 2,318; age 60 +/- 10 years), undergoing a routine exercise test at the Veterans Affairs Medical Center, Washington, DC. Antihypertensive therapy included angiotensin-converting enzyme inhibitors (n = 437), calcium-channel blockers (n = 223), diuretics (n = 226), and combinations (n = 1,442), beta-blockers alone (n = 201) or in combination with other antihypertensive agents (n = 467), and none (n = 208). Exercise BP, heart rate (HR) and rate-pressure product (RPP) at maximal and submaximal workloads were assessed. RESULTS: After adjusting for covariates, patients treated with beta-blockers or beta-blocker-based ...
Exercise treadmill tests are offered for those patients interested in an exercise prescription. Exercise prescription is important for patients who are starting to exercise and want a plan to perform it safely and effectively.
Introduction. Considerable doubt remains about whether the warm-up effect in angina represents ischaemic preconditioning (IPC), or is simply due to improved myocardial perfusion via acute recruitment of collaterals. We investigated the latter possibility using quantitative tetrofosmin SPECT. Methods. 11 patients (age 63±8 years, 8 male) with coronary disease and preserved left ventricular function underwent symptom-limited treadmill exercise off antianginal medication. On three separate days at weekly intervals, 99m Tc-tetrofosmin 400-450MBq was injected at rest, during a single exercise test (Ex1), and during the second of two exercise tests separated by 30 minutes (Ex2a and Ex2b). Exercise injections were given at equivalent heart rates. SPECT acquisitions were obtained 1-2 hours after each tetrofosmin injection. Quantitative analysis was performed by comparing polar plots derived from radial slices with a normal database. The hypoperfusion index was the product of
Objectives: To assess the association between impaired chronotropic response (CR) and adverse events among patients with diabetes referred for exercise treadmill testing (ETT).. Research design and methods: Impaired CR was defined as achievement of less than 80% of a patients heart rate reserve. Multivariable Cox proportional hazards regression assessed the independent association between impaired CR and adverse outcomes adjusting for demographics, co-morbidities and treadmill variables including the Duke Treadmill score.. Results: Of 1,341 patients with diabetes, 35.7% (n=479) demonstrated impaired CR during ETT. Patients with impaired CR were at increased risk of all-cause mortality, myocardial infarction, or coronary revascularization procedures. In multivariable analyses, impaired CR remained significantly associated with adverse outcomes (HR 1.53; 95% CI 1.10-2.14).. Conclusions: Among patients with diabetes, impaired CR is common during ETT and is associated with adverse outcomes. ...
A study published in the European Journal of Preventive Cardiology10 sought to estimate a patients age based on performance during an exercise stress test. Over a 125,000 patients referred for exercise stress testing were included.. Estimated age was based on exercise capacity. After nearly nine years of follow-up, researchers discovered the patients estimated age based on their exercise stress test was a better predictor of mortality as compared to chronological age. The results held true for both men and women.. Researchers believe the key take-home messages were that exercise variables are powerful predictors of survival, and health care providers could consider using their physiological age as a way to motivate their patients to exercise more.11 A similar study12 evaluated 8,000 middle-aged and older adults and found adding physical activity of any intensity or duration cut their risk of early death.. The researchers believe the findings highlight the importance of movement, regardless of ...
is known from exercise testing, as opposed to estimating target heart rate or work rate from age-predicted calculations. In addition, in cases where ischemia or arrhythmias are induced at higher exercise intensities, exercise test results could be used to keep exercise intensity below the ischemic threshold. Exercise testing also can be useful for risk stratification, given that lower aerobic capacity (27) and the presence of ischemic changes on ECG (28) are each associated with higher risks of cardiovascular and overall morbidity and mortality. Exercise testing can also sometimes detect previously unsuspected coronary disease. However, no trial has specifically assessed whether exercise stress testing before beginning an exercise program reduces coronary morbidity or mortality. Furthermore, a recent randomized trial found that screening of asymptomatic people with diabetes and additional cardiac risk factors using exercise ECG stress testing (or dipyridamole single photon emission computed ...
BUSTAMANTE, L et al. Discrimination of exercise limitation in submaximal and maximal exercise tests in severe COPD patients. Rev. amer. med. respiratoria [online]. 2011, vol.11, n.1, pp.18-23. ISSN 1852-236X.. There are no data about symptoms of activity limitation in COPD patients when maximal and submaximal exercise tests are compared. Objective: To compare the activity limitation by dyspnea or fatigue between maximal and submaximal exercise tests. Methods: Moderate and severe COPD patients were included (GOLD definition). They were classified as fatigue limited (FL) if Borg scale of fatigue at maximal exercise was ≥ 2 points vs. dyspnea; and dyspnea limited (DL) if it was the reverse. Each patient was evaluated in the same way with submaximal cycloergometry. Results: 15 patients in the LD group and 18 patients in the LF group were evaluated. The LF patients were mainly women (FL 55.5 vs. DL 26.6% p: 0.034), had a low body-mass index (FL 24.1 ± 3.2 vs. DL 26.8 ± 2.1; p,0.04) and less ...
We have shown that, in patients with permanent AF with a mixed ventricular response rate, improved rate control will lead to a significant improvement in exercise duration and quality of life with equal preservation of a normal left ventricular function. However, rate regulation by ablation conferred no additional benefit compared to rate control alone in this patient group.. Patients with permanent AF often complain of limited exercise capacity and breathlessness despite a normal left ventricular function. In these patients assessment of ventricular rate control must be done thoroughly. Reliance on the ventricular rest rate at clinic visits is inadequate, as it gives no indication of the heart rate response to exercise. In this study the resting heart rate prior to exercise in the medical group did not significantly change from baseline at any follow up. However, at baseline there was poor rate control evident on exercise testing. Therefore assessment for rate control should include exercise ...
Nuclear stress test utilizes nuclear isotope (most commonly Cardiolite) which traces blood flow to the heart. This nuclear tracer in the blood is taken up by heart muscle in proportion to coronary blood flow, i.e., normal uptake if the flow is intact and less uptake if the flow is reduced due to coronary blockage. This blood flow pattern is shown by nuclear camera which scans the small amount of radioactivity emitted by the isotope taken up by heart tissue. Hence the test is primarily designed to detect signs of coronary artery disease. This isotope is well-tolerated by most and is cleared from the body in 24 to 36 hours.. This is carried out in two parts: stress images and resting images. The stress part can be done with treadmill stress test or chemical stress test (most commonly Lexiscan or Persantine) if you cannot physically exercise. At peak exercise or following injection of Lexiscan, Cardiolite is injected and the patient is scanned under the nuclear camera. The resting images are also ...
HealthDay News) - For adult survivors of childhood acute lymphoblastic leukemia (ALL), exercise intolerance is associated with worse neurocognitive outcomes, according to a study published online Oct. 21 in Cancer.. Nicholas S. Phillips, M.D., Ph.D., from St. Jude Research Hospital in Memphis, Tennessee, and colleagues obtained cardiopulmonary exercise test results, results from a two-hour standardized neuropsychological assessment, and self-report questionnaires for 341 adult survivors of childhood ALL and 288 controls. The authors examined the correlations between oxygen uptake at 85 percent estimated heart rate (rpkVO2) and neurophysiological test and self-reported questionnaire domains.. The researchers found that survivors had worse rpkVO2 and performance on verbal intelligence, focused attention, verbal fluency, working memory, dominant/nondominant motor speed, visual-motor speed, memory span, and measures of reading and math than controls. In survivors, exercise intolerance correlated ...
article{48954, author = {C Cotrim and I Joao and J Guardado and P Cordeiro and M ANA Sampaio and A Marques and H Cafe and R Martins and H Cotrim and L Baquero}, title = {Treadmill exercise stress echocardiography in children; our experience.}, journal = {European Heart Journal - Cardiovascular Imaging}, year = 2020, volume = 21 } ...
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TY - JOUR. T1 - Repeat treadmill exercise testing. T2 - Variability of results in patients with angina pectoris. AU - Starling, Mark R.. AU - Moody, Mark. AU - Crawford, Michael H.. AU - Levi, Bernard. AU - ORourke, Robert A.. PY - 1984/2. Y1 - 1984/2. N2 - To assess the reproducibility and individual variability of ECG treadmill exercise test results, we evaluated 23 patients with coronary artery disease and stable exertional angina by means of two control exercise tests performed on different days within a 1 week period. In addition, each control test was followed on the same day by a single dose of placebo or active agent determined in a randomized double-blind manner and the exercise test was repeated. When the mean exercise test results from the control tests on days 1 and 2 were compared, there was a significant increase in exercise duration to angina (7.4 ± 3.2 to 9.0 ± 3.3 minutes, p , 0.05), ST segment depression (7.8 ± 3.9 to 9.6 ± 3.6 minutes, p , 0.01), and maximal exercise (9.7 ...
The relative efficacy of nicardipine and nifedipine was examined in a double-blind placebo-controlled randomized crossover trial. We studied 12 patients with chronic effort angina involving reproducible angina and greater than or equal to 1.5 mm of ST-segment depression on exercise treadmill test performed before and after a 1-week control period of single-blind placebo administration. Subsequently, indistinguishably prepared nicardipine 20 mg, nifedipine 10 mg, or placebo, four times a day, was administered in a randomized double-blind crossover fashion for 3 weeks (total study period 9 weeks). Exercise treadmill test was performed at the end of each 3-week period. Both nicardipine and nifedipine significantly reduced the frequency of anginal attacks and nitroglycerin consumption. Compared with placebo both drugs caused a comparable increase of the duration of exercise, of the time to angina and to the appearance of 1.5 mm ST-segment depression (P less than 0.05 placebo versus nicardipine; P ...
TY - JOUR. T1 - Capabilities of supine exercise electrocardiography versus exercise radionuclide angiography in predicting coronary events. AU - Simari, Robert D.. AU - Miller, Todd D.. AU - Zinsmeister, Alan R.. AU - Gibbons, Raymond J.. PY - 1991/3/15. Y1 - 1991/3/15. N2 - The ability of supine exercise electrocardiography and exercise radionuclide angiography to predict time to subsequent cardiac events (cardiac death, nonfatal myocardial infarction or late coronary bypass grafting or angioplasty) were compared in 265 patients with normal resting electrocardiograms who were not taking digoxin. All patients had undergone coronary catheterization and were initially treated medically. Follow-up study was performed at a median of 51 months. Separate logistic regression models, which had been previously developed to predict 3-vessd or left main coronary artery disease (CAD), were compared using a Cox regression analysis to predict time to a subsequent cardiac event. The exercise ...
To evaluate the effectiveness of the graded exercise test in predicting the extent of coronary artery disease and the degree of left ventricular dysfunction in patients with prior myocardial infarction, 100 consecutive patients underwent both graded exercise testing and coronary and left ventricular angiography at a median of 4 months after infarction. The studies caused no complications. An equal number of patients had anterior and inferior infarction. Coronary artery disease, defined as 70 percent or greater stenosis of luminal diameter, was present in three vessels in 31 patients, in two vessels in 35 patients, in one vessel in 33 patients and in no vessel in one patient. With diagnostic electrocardiographic criteria of 1 mm or greater J point depression plus a flat or downsloping S-T segment, 31 patients had an electrocardiographically positive exercise test; 27 of these (87 percent) had two or three vessel coronary artery disease. Of the 21 patients with a negative exercise test, 62 ...
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Commentary from Dr. Jared Hershenson (Greater Washington DC), section editor of Pediatric Cardiology Journal Watch: Exercise stress echocardiography (ESE) is not a commonly used modality in pediatric patients and there are few published studies reporting the utility of ESE in this population. ESE is commonly used to assess cardiac function in adults with coronary issues, hypertrophic cardiomyopathy (HCM), aortic valve disorders, and EKG abnormalities (e.g. LBBB), but some pediatric labs have started to use ESE in pediatric patients with many of the above issues. The primary aim of this study was to evaluate the utility of ESE in a large single pediatric program and a secondary aim was to see how ESE impacted clinical management. Test indications were divided into 5 categories: 1) symptoms with exercise, 2) sports/activity clearance, 3) HCM, 4) coronary abnormalities, and 5) abnormal EKG. It was not clearly stated, but patients with pre-existing CHD (besides coronary anomalies) were seemingly ...
Although the burden of sickle cell anemia (SCA) on affected individuals is significant, few studies have examined the influence of having SCA on such measures of physical function as exercise capacity. Moreover, the physiologic basis of poor physical functioning in children with SCA is unknown and has not been studied extensively. The purpose of this proposal is to use cardiopulmonary exercise testing (CPET) to gain a comprehensive understanding of longitudinal changes in exercise capacity, and the effect of poor exercise capacity on quality of life in children and young adults with SCA. The specific aims of this project are to: 1) Measure peak oxygen consumption (VO2), the reference standard for exercise capacity, in children and young adults with SCA classified by primary pathophysiologic contributor to their decreased exercise capacity, and 2) compare results of this exercise test with the results of previously completed exercise tests to determine longitudinal changes in exercise capacity. ...
TY - JOUR. T1 - Exercise capacity in patients with severe left ventricular dysfunction. AU - Benge, John William. AU - Litchfield, R. L.. AU - Marcus, M. L.. PY - 1980/1/1. Y1 - 1980/1/1. N2 - Normal or near-normal exercise capacity has been thought to reflect normal left ventricular function. Many compensatory mechanisms could preserve exercise capacity in patients with severe left ventricular dysfunction. We evaluated exercise capacity using a treadmill exercise test in 26 patients with severe left ventricular dysfunction defined by a left ventricular ejection fraction of 30% or less by isotope ventriculography. One half of the patients had normal exercise capacity and a normal cardiothoracic ratio on chest x-ray. This study indicates that traditional predictors of left ventricular function that have been widely used in clinical evaluation of the patients with cardiac disease (cardiothoracic ratio and exercise capacity) can be normal in a significant number of patients with severe left ...
TY - JOUR. T1 - Oxynet. T2 - A collective intelligence that detects ventilatory thresholds in cardiopulmonary exercise tests. AU - Zignoli, A.. AU - Fornasiero, A.. AU - Rota, P.. AU - Muollo, V.. AU - Peyré-Tartaruga, L. A.. AU - Low, D. A.. AU - Fontana, F. Y.. AU - Besson, D.. AU - Pühringer, M.. AU - Ring-Dimitriou, S.. AU - Mourot, L.. N1 - Funding Information: We are thankful to Amedeo Setti (ProM Facility, Trentino Sviluppo) for developing the web-based applications and for managing the data collection and storage on the cluster of servers. We are thankful to the CARITRO Foundation for partially supporting this project and for establishing the Deep Learning Lab at the ProM Facility (Trentino Sviluppo). Appreciation is expressed to Filippo Degasperi for supporting the Oxynet web-application development within the Restitution Project. Publisher Copyright: © 2021 European College of Sport Science. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.. PY - 2021. Y1 - 2021. N2 - ...
Eighteen male patients (aged 40-66 years) with confirmed ischaemic heart disease and a minimum of four angina attacks per week were included in a double-blind comparison of dilevalol 200 mg, dilevalol 400 mg and atenolol 100 mg. Following a one-week placebo run-in period patients were randomly allocated to one of the three treatments, after which they crossed to the remaining two treatments according to a balanced Latin square design. Each treatment was given once-daily over four weeks. Symptom-limited treadmill exercise testing using a modified Bruce protocol was performed at the end of placebo, and after each treatment around 24 hours post-dosing. The mean exercise time on placebo was 7.0 (+/- 0.91) minutes which changed to 7.8 (+/- 0.93) minutes on dilevalol 200 mg, 7.3 (+/- 0.88) minutes on dilevalol 400 mg and 8.2 minutes (+/- 1.06) on atenolol 100 mg. Nine patients had a greater exercise tolerance on dilevalol (200 or 400 mg), and nine a greater exercise tolerance on atenolol. Maximum exercise
The peak heart rate becomes important when using the chronotropic index. Studies have shown that men who score less than 0.8 on the chronotropic index have a higher risk of dying prematurely. However, this study assumed that the peak heart rate is 220 minus age. It has been found that this assumption made the prediction of premature death less useful for women. The new formula for peak heart rate may improve the prediction of the chronotropic index for women ...
Cycle and treadmill exercise tests are unsuitable for elderly, frail and severely limited patients with heart failure and may not reflect capacity to undertake day-to-day activities. Walking tests have proved useful as measures of outcome for patients with chronic lung disease. To investigate the potential value of the 6-minute walk as an objective measure of exercise capacity in patients with chronic heart failure, the test was administered six times over 12 weeks to 18 patients with chronic heart failure and 25 with chronic lung disease. The subjects also underwent cycle ergometer testing, and their functional status was evaluated by means of conventional measures. The walking test proved highly acceptable to the patients, and stable, reproducible results were achieved after the first two walks. The results correlated with the conventional measures of functional status and exercise capacity. The authors conclude that the 6-minute walk is a useful measure of functional exercise capacity and a ...
Purpose: Allometric is a method for the expression of relationship between the physiological variables, anatomical with unit of the body size that through mathematical methods can calculate vital capacity. The aim of this study was to evaluation of pulmonary function for estimation of peak oxygen consumption through the respiratory gas analysis and allometric equation in boy student. Methods: In this causal after the occurrence study, 80 subjects were selected by convenience sampling. Characteristics of anthropometric, chest circumference (diameter and depth of the chest), and for estimation of peak oxygen consumption, Bruce test, where was measured using the validated methods. Data were analyzed using Pearson correlation and multiple regressions in SPSS version 16. Result: There were not significant correlations between TV, IRV, ERV, and FVC with peak oxygen consumption. While, There was significant positive correlation between FVC and peak oxygen consumption (p=0.041 & r=0.229) and between ...
THURSDAY, Nov. 16, 2017 (HealthDay News) - Supervised treadmill exercise, but not granulocyte-macrophage colony-stimulating factor (GM-CSF), improves six-minute walking distance among patients with peripheral artery disease (PAD), according to a study published online Nov. 15 in the Journal of the American Medical Association to coincide with the American Heart Associations Scientific Sessions, held Nov. 11 to 15 in Anaheim, California.. Mary M. McDermott, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues randomized patients with PAD to receive supervised exercise + GM-CSF (exercise + GM-CSF; 53 participants), supervised exercise + placebo (exercise alone; 53 participants), attention control + GM-CSF (GM-CSF alone; 53 participants), and attention control + placebo (51 participants).. The researchers found that there was no significant improvement in the six-minute walk distance for exercise + GM-CSF versus exercise alone (mean difference, −6.3 m [95 ...
Several rebreathing methods are available for cardiac output (QT) measurement. The aims of the study were threefold: first, to compare values for resting QT produced by the equilibrium-CO2, exponential-CO2 and inert gas-N2O rebreathing methods and, second, to evaluate the reproducibility of these three methods at rest. The third aim was to assess the agreement between estimates of peak exercise QT derived from the exponential and inert gas rebreathing methods. A total of 18 healthy subjects visited the exercise laboratory on different days. Repeated measures of QT, measured in a seated position, were separated by a 5 min rest period. Twelve participants performed an incremental exercise test to determine peak oxygen consumption. Two more exercise tests were used to measure QT at peak exercise using the exponential and inert gas rebreathing methods. The exponential method produced significantly higher estimates at rest (averaging 10.91min -1) compared with the equilibrium method (averaging ...
Methods and Results Blood pressure at rest and during exercise, parental smoking, and other familial risk factors were investigated in 532 adolescents aged 12 to 17 years (14.6±1.5 years) in the Kiel EX.PRESS. (EXercise PRESSure) Study. Exercise blood pressure was determined at 1.5 W/kg body weight using a standardized submaximal cycle ergometer test. Mean resting blood pressure was 113.1±12.8/57.2±7.1 mm Hg, and exercise blood pressure was 149.9±19.8/54.2±8.6 mm Hg. Parental smoking increased exercise systolic blood pressure (+4.0 mm Hg, 3.1 to 4.9; P=0.03) but not resting blood pressure of the subjects (adjusted for age, sex, height, body mass index percentile, fitness). Parental overweight and familial hypertension were related to both higher resting and exercise systolic blood pressure values, whereas associations with an inactive lifestyle and a low educational level of the parents were found only with adolescents blood pressure during exercise. The cumulative effect of familial risk ...
The purpose of this study was to compare the ventilatory threshold (VT) between treadmill walking against a horizontal impeding force (horizontal load walking) and a cycle ergometer exercise. Seven adult men volunteered to participate in this study. They performed horizontal load walking (velocity: 1.11 m/s) and a cycle ergometer exercise (pedaling frequency: 60 rpm), with loads imposed using a ramp slope technique. Oxygen uptake at the VT during horizontal load walking was greater than that during a cycle ergometer exercise (p
The aim of the present study was to investigate the relationship between speed during maximum exercise test (ET) and oxygen consumption (VO2) in control and STZ-diabetic rats, in order to provide a useful method to determine exercise capacity and prescription in researches involving STZ-diabetic rats. Male Wistar rats were divided into two groups: control (CG, n = 10) and diabetic (DG, n = 8). The animals were submitted to ET on treadmill with simultaneous gas analysis through open respirometry system. ET and VO2 were assessed 60 days after diabetes induction (STZ, 50 mg/Kg). VO2 maximum was reduced in STZ-diabetic rats (72.5 ± 1 mL/Kg/min-1) compared to CG rats (81.1 ± 1 mL/Kg/min-1). There were positive correlations between ET speed and VO2 (r = 0.87 for CG and r = 0.8 for DG), as well as between ET speed and VO2 reserve (r = 0.77 for CG and r = 0.7 for DG). Positive correlations were also obtained between measured VO2 and VO2 predicted values (r = 0.81 for CG and r = 0.75 for DG) by linear
A Practical Guide to the Interpretation of Cardiopulmonary Exercise Tests is a short, but comprehensive, guide for those who are involved in the supervision of exercise tests and interpretation of cardiopulmonary exercise test (CPET) data. It is a clear and concise guide which will also be of interest to those who request CPETs and who wish to understand more about how to use the results. The first four chapters cover the reasons why a CPET may be requested, pre-test assessment, supervision of the test to ensure that it is safe, and the practicalities of the test itself. Subsequent chapters look in detail at the key CPET measurements of heart rate, ventilation, oxygen uptake, and carbon dioxide output. There are chapters on the parameters that can be derived from these basic measurements: ventilatory equivalents, oxygen pulse, and the respiratory exchange ratio. Further chapters show how the anaerobic threshold and respiratory compensation point are obtained, and how they can be used to ...
Exercise has been proposed for the treatment of traumatic brain injury (TBI). However, the proper intensity of exercise in the early phase following a severe TBI is largely unknown. To compare two different treadmill exercise intensities on the cognitive function following a severe TBI in its early phase, rats experienced a controlled cortical impact (CCI) and were forced to treadmill exercise for 14 days. The results revealed that the rats in the low intensity exercise group had a shorter latency to locate a platform and a significantly better improvement in spatial memory in the Morris water maze (MWM) compared to the control group (p < 0.05). The high intensity exercise group showed a longer latency and a mild improvement in spatial memory compared to the control group rats in the MWM; however, this difference was not statistically significant (p > 0.05). The brain-derived neurotrophic factor (BDNF) and p-CREB protein levels in the contralateral hippocampus were increased significantly in the
Exercise has been proposed for the treatment of traumatic brain injury (TBI). However, the proper intensity of exercise in the early phase following a severe TBI is largely unknown. To compare two different treadmill exercise intensities on the cognitive function following a severe TBI in its early phase, rats experienced a controlled cortical impact (CCI) and were forced to treadmill exercise for 14 days. The results revealed that the rats in the low intensity exercise group had a shorter latency to locate a platform and a significantly better improvement in spatial memory in the Morris water maze (MWM) compared to the control group (p < 0.05). The high intensity exercise group showed a longer latency and a mild improvement in spatial memory compared to the control group rats in the MWM; however, this difference was not statistically significant (p > 0.05). The brain-derived neurotrophic factor (BDNF) and p-CREB protein levels in the contralateral hippocampus were increased significantly in the
Exercise stress tests are used to determine how well your heart handles physical activity. Learn what to expect from an exercise stress test here at Ohio State.
Women who measure their peak heart rates for exercise will need to do some new math, as will physicians giving stress tests to patients. A new formula based on a large study from Northwestern Medicine provides a more accurate estimate of the peak heart rate a healthy woman should attain during exercise.
abnormal heart rate recovery immediately after treadmill testing : correlation with clinical, exercise testing, and myocardial perfusion parameters. introductionthe heart is under influence of both divisions of the autonomic nervous system. the sympathetic system has positive chronotropic action whereas the parasympathetic system has negative chronotropic action. previous studies have shown that imbalance betwe
Exercise Target Heart Rate Checker Your maximum heart rate is calculated by subtracting your age from 220 for men and 226 for women. Your target heart rate zone is 50-75% of your maximum heart rate. I
A Stress Echocardiogram is a non-invasive test that combines two tests: a treadmill stress test and an echocardiogram (an ultrasound of the heart). If there are any abnormalities in heart function after exercise, this may be due to a blocked artery or coronary artery disease (CAD). This information is useful to your doctor to help establish a diagnosis and guide your treatment.. What to Expect During a Stress Echocardiogram. A stress echocardiogram is done by a cardiologist who is assisted by a specially certified technician called an echocardiographer. The echocardiographer will begin by placing electrodes on your chest to monitor your heart rate and rhythm throughout the test. First the echocardiogram will be performed at rest while you lie on the exam table.. Immediately following, you will begin to walk on the treadmill, which normally gets faster and steeper every three minutes. You will exercise until the doctor says you have done enough or you indicate that you have done enough. If you ...
Thallium Stress Test (Thallium 201 Exercise Test) is the same as a treadmill exercise test. This test checks the function of the heart during and after physical activity.
Supervised exercise (SE) in patients with type 2 diabetes improves oxygen uptake kinetics at the onset of exercise. Maintenance of these improvements, however, has not been examined when supervision is removed. We explored if potential improvements in oxygen uptake kinetics following a 12-week SE that combined aerobic and resistance training were maintained after a subsequent 12-week unsupervised exercise (UE). The involvement of cardiac output (CO) in these improvements was also tested. Nineteen volunteers with type 2 diabetes were recruited. Oxygen uptake kinetics and CO (inert gas rebreathing) responses to constant-load cycling at 50% ventilatory threshold (VT), 80% VT, and mid-point between VT and peak workload (50% Δ) were examined at baseline (on 2 occasions) and following each 12-week training period. Participants decided to exercise at a local gymnasium during the UE. Thirteen subjects completed all the interventions. The time constant of phase 2 of oxygen uptake was significantly ...
Fitness may be a strong predictor of high blood pressure, according to a study linking increased fitness levels to reduced risk of hypertension.. Hypertension, often referred to as high blood pressure, is a potentially life-threatening condition that affects one in three U.S. adults. Not only does high blood pressure often cause no symptoms, it drastically increases risk of heart disease, heart attack and stroke. The good news is that regular physical activity helps promote a healthy blood pressure and according to research, the more fit you are, the lower your blood pressure may be. Published in the Journal of the American Heart Association, this study tested the fitness levels of more than 57,200 individuals participating in The Henry Ford Exercise Testing Project, which studied the relationship between fitness and heart health. Using treadmill stress tests, researchers tested the fitness level of participants between 1991 and 2009, and then collected key health information, including blood ...
Introduction: Cardiovascular mortality has risen in the last few years and Ischemic Heart Disease (IHD) is one of the most common causes. Ischemia Reversal Program (IRP) kit uses a combination of Snehana (Centripetal oleation), Swedana (Thermal vasodilation) and Basti (Per rectal drug administration) for providing relief to IHD patients. This study was conducted to evaluate the efficacy of IRP in IHD patients. Methods: This retrospective study included data of patients having positive inducible ischemia by stress test with known history of hypertension (HTN) and had visited the Madhavbaug clinics. A minimum of 7 IRP sittings were needed for inclusion. Duke Treadmill score, VO2 max, systolic plus diastolic blood pressure (SBP, DBP) and details of conventional medications were noted on day 1 and on day 90 followed by comparison between these values. Results: 19 patients having mean age 59.26 ± 8.03 years were enrolled, with 78.9% being males. On day 90, none of the patients were at high risk by ...
Cardiopulmonary exercise test (CPET) is a functional assessment that helps to detect disorders affecting the system involved in oxygen transport and utilization through the analysis of the gas exchange during exercise. The clinical application of CPET is various, it including training prescription, evaluation of treatment efficacy and outcome prediction in a broad spectrum of conditions. Furthermore, in patients with shortness of breath it provides pivotal information to bring out an accurate differential diagnosis between physical deconditioning, cardiopulmonary disease and muscular diseases. Modern software allows the breath-by-breath analysis of the volume of oxygen intake (VO2), volume of carbon dioxide output (VCO2) and expired air (VE). Through this analysis, CPET provides a series of additional parameters (peak VO2, ventilatory threshold, VE/VCO2 slope, end-tidal carbon dioxide exhaled) that characterize different patterns, helping in diagnosis process. Limitations to the routine use of CPET are
resting heart rate. To calculate your heart rate reserve, you need to know your age (you should know this!), and your resting heart rate. Suppose your resting heart rate is 60 beats per minute (bpm). Your maximum heart rate is still calculated as 220 - your age ie 184bpm. But your heart rate reserve is now given as the difference between resting and maximum heart rate, or 184 - 60bpm = 124bpm.. If you work at 75% of your heart rate reserve, youll be training at 75% of 124bpm over and above your resting heart rate ie 93bpm above 60bpm, which is 153bpm. At 80% of heart rate reserve, its 80% of 124bpm over and above resting heart rate, which is 99bpm above 60bpm or 159bpm. Your 75-80% training zone therefore is 153bpm - 159bpm.. Although its slightly more complex to apply, the Karvonen formula more accurately reflects the working % of your maximum oxygen uptake than does a simple % of max heart rate calculation, particularly for fitter people. So for example, youre much more likely to be ...
Background: Non-invasive diagnostic imaging of atherosclerotic coronary artery disease (CAD) is frequently carried out with cardiovascular magnetic resonance imaging (CMR) or myocardial perfusion single photon emission computed tomography (MPS). CMR is the gold standard for the evaluation of scar after myocardial infarction and MPS the clinical gold standard for ischemia. Magnetic Resonance Imaging (MRI) is at times difficult for patients and may induce anxiety while patient experience of MPS is largely unknown.. Aims: To evaluate image quality in CMR with respect to the sequences employed, the influence of atrial fibrillation, myocardial perfusion and the impact of patient information. Further, to study patient experience in relation to MRI with the goal of improving the care of these patients.. Method: Four study designs have been used. In paper I, experimental cross-over, paper (II) experimental controlled clinical trial, paper (III) psychometric crosssectional study and paper (IV) ...
A cardiac stress test (also referred to as a cardiac diagnostic test, cardiopulmonary exercise test, or abbreviated CPX test) is a cardiological test that measures a hearts ability to respond to external stress in a controlled clinical environment. The stress response is induced by exercise or by drug stimulation. Cardiac stress tests compare the coronary circulation while the patient is at rest with the same patients circulation during maximum physical exertion, showing any abnormal blood flow to the myocardium (heart muscle tissue). The results can be interpreted as a reflection on the general physical condition of the test patient. This test can be used to diagnose coronary artery disease (also known as ischemic heart disease) and assess patient prognosis after a myocardial infarction (heart attack). The cardiac stress test is done with heart stimulation, either by exercise on a treadmill, pedalling a stationary exercise bicycle ergometer, or with intravenous pharmacological stimulation, ...
In this pilot study, the authors investigated the feasibility of a home-based, remotely guided exercise intervention for patients with gliomas. This was achieved through a pilot randomized controlled trial (RCT) with randomization (2:1) to exercise or control group.. The six-month intervention included three home-based exercise sessions per week at 60%-85% of maximum heart rate. Participants wore heart rate monitors connected to an online platform to record activities that were monitored weekly by the physiotherapist. Accrual, attrition, adherence, safety, satisfaction, patient-reported physical activity, VO2 peak (by maximal cardiopulmonary exercise testing) and body mass index (BMI) were all measured at baseline and at six-month follow-up.. In all, 34 of 136 eligible patients (25%) were randomized to exercise training ( N = 23) or the control group ( N = 11), of whom 19 and 9, respectively, underwent follow-up. Mean adherence to prescribed sessions was 79%. Patients experiences were positive. ...
By Jackie Brinkman , University Communications. AURORA, Colo. - Researchers at the University of Colorado have new insight into the age-old question of why maximum heart rate (maxHR) decreases with age. This decrease in maxHR not only limits the performance of aging athletes but it is also a leading cause for nursing home admittance for otherwise-healthy elderly individuals who no longer have the physical capacity required for independent living. We say were just getting old and slowing down, but exactly what is it that is slowing down?. Everybody knows that aerobic capacity decreases with age. You know that chart in your gym that shows your target heart rate decreasing as you get older? Well, thats not a senior discount to let the elderly get off easy on their treadmill workouts. Its because older hearts simply cant beat as fast as younger hearts. So the older person whos doing 120 beats per minute is probably working harder - at a higher percentage of maximum heart rate - than the younger ...
BACKGROUND: Functional mitral regurgitation (MR) is common in patients with heart failure and left ventricular (LV) dysfunction, and its severity may vary over time, depending primarily on the loading conditions. Because dynamic changes in the severity of functional MR may affect forward stroke volume, we hypothesized that exercise-induced changes in MR severity influence the stroke volume response of patients with LV dysfunction to exercise, and hence their exercise capacity. METHODS AND RESULTS: Heart failure patients (n=25; mean age 53+/-12 years) with LV dysfunction underwent dynamic bicycle exercise at steady-state levels of 30%, 60%, and 90% of predetermined peak VO2. During each exercise level, right heart pressures, cardiac output, VO2, and MR severity were measured simultaneously. During exercise, MR severity, as evaluated by the ratio of MR jet over left atrium area, increased from 15+/-8% to 33+/-15%. Peak VO2, exercise-induced changes in stroke volume, and those in capillary wedge ...